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脑血管支架置入术后再狭窄的危险因素、治疗措施及预防

发布时间:2019-01-11 18:30  文章来源:笔耕文化传播
【摘要】:目的:探讨脑血管支架置入术后再狭窄的影响因素、治疗措施及预防。方法:回顾性分析120例脑血管支架置入术后患者临床资料,CTA或DSA随访6-12月(平均9个月),根据出现支架部位分为颈内动脉支架组(74例)及椎动脉支架组(46例),各组根据是否出现狭窄分为再狭窄组和未狭窄组,其中颈内动脉支架组再狭窄组(10例)和未狭窄组(64例),椎动脉支架组再狭窄组(21例)和未狭窄组(25例)。分析支架置入后再狭窄是否与支架类型、高血压、糖尿病、规律服用抗血小板凝集药物等因素的相关性。结果:椎动脉支架置入术后再狭窄组与未狭窄组中高密度脂蛋白(t=2.24,P0.05),患有糖尿病为9例和5例(χ2=4.06,P0.05)。甘油三酯、低密度脂蛋白、冠心病、高血压、吸烟、饮酒等危险因素对椎动脉支架均无统计学意义。颈内动脉支架置入术后再狭窄组与未狭窄组,患有冠心病为1例和4例(χ2=20.08,P0.05)。甘油三脂、低密度脂蛋白、高密度脂蛋白、高血压、糖尿病、饮酒、吸烟等危险因素对颈内动脉支架均无统计学意义。术后3-6个月内规律抗血小板凝集治疗与支架内再狭窄有关。结论:椎动脉支架置入术后再狭窄与是否与患有糖尿病及高密度脂蛋白有关,颈内动脉支架置入术后再狭窄与冠心病有关。支架内再狭窄与是否规律服用抗血小板凝集药物有关。椎动脉支架内再狭窄率高于颈内动脉支架再狭窄率。其他相关因素有待进一步研究。
[Abstract]:Objective: to investigate the influencing factors, treatment and prevention of restenosis after cerebrovascular stent implantation. Methods: the clinical data of 120 patients after cerebrovascular stenting were retrospectively analyzed. CTA or DSA were followed up for 6-12 months (mean 9 months). According to the location of stents, they were divided into internal carotid artery stent group (74 cases) and vertebral artery stent group (46 cases). Each group was divided into restenosis group (n = 10) and non-stenosis group (n = 64), restenosis group (n = 21) and non-stenosis group (n = 25). To analyze whether restenosis after stent placement is related to stent type, hypertension, diabetes mellitus, regular administration of antiplatelet agglutinin, and so on. Results: high density lipoprotein (HDL-C) was found in restenosis group and non-stenosis group after vertebral artery stenting, 9 cases and 5 cases with diabetes mellitus (蠂 2 / 4.06 P 0.05). Triglyceride, low density lipoprotein, coronary heart disease, hypertension, smoking, drinking and other risk factors had no statistical significance in vertebral artery stents. There were 1 case and 4 cases of coronary heart disease in restenosis group and non-stenosis group after internal carotid artery stenting (蠂 2 20.08 P 0.05). Triglyceride, low density lipoprotein, hypertension, diabetes, alcohol, smoking and other risk factors had no statistical significance in carotid artery stents. Regular anti-platelet agglutination was associated with stent restenosis 3-6 months after operation. Conclusion: restenosis after vertebral artery stenting is associated with diabetes mellitus and high density lipoprotein, and restenosis after internal carotid artery stenting is associated with coronary heart disease. Stent restenosis is associated with regular administration of antiplatelet agglutinants. The rate of in-stent restenosis in vertebral artery was higher than that in internal carotid artery. Other relevant factors need further study.
【学位授予单位】:新疆医科大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R743

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